DEPARTMENT OF HEALTH & HUMAN SERVICES

Public Health Service Centers for Disease Control

Memorandum Date

January 5, 1987

Public Health Analyst and Mark W. Oberle, M.D.,

of

(PEB), Division Branch Assistant Chief, Program Evaluation M.P.H., (CHPE)

Education and Reproductive Health (DRH), Center for Health Promotion

Anthony A. Hudgins, M.A.S., From

Mexico, October

Foreign Trip Report (AID/RSSA): Mexico City and Manzanillo, Priority

Subect 22-23 and November 17-28, 1986--Workshop on Logistics Management For Health Programs

To

James 0. Mason, M.D., Dr.P.H.

Director, CDC

Through: Assistant Director for Science, CHPE

SUMMARY

I. PLACES, DATES, AND PURPOSE OF TRAVEL

II. PRINCIPAL CONTACTS

III. LOGISTICS MANAGEMENT WORKSHOP

IV. CONCLUDING COMMENTS

Attachment A: Workshop Schedule

List of Participants

Attachment B: SUMMARY

of the

From November 17 to November 28, 1986, Mark Oberle and Anthony Hudgins Health

of Ministry the Division of Reproductive Health visited Mexico to assist Workshop

(MOH) in the preparation and presentation of a Logistics Management Oral

focusing on five priority health programs (Family Planning, Nutrition, The workshop was largely

Rehydration, Immunization, and Malaria Control). Contraceptive Logistics

International an for DRH based on material developed by 1986.

January in Colombia, Management Workshop conducted in Bogota, planning The first week was spent reviewing workshop materials and in City. discussions with workshop faculty at the MOH headquarters in Mexico Manzanillo During the second week (November 24-28), the workshop was held in of the

much chagrin, our to Although, States. 12 for 24 participants from host

the

by minute last the at deleted was important didactic content define

to States the for

forum government, the workshop provided a useful However, most of the

their working relationship with the Federal level. training objectives for contraceptive logistics management were not attained.

I.

PLACES, DATES AND PURPOSE OF TRAVEL

From November 16 to November 29, 1986, Mark Oberle and Anthony A. Hudgins

preparing

traveled to Mexico City and Manzanillo, Mexico, to assist the MOH in participants

24 for and presenting a 1-week workshop in logistics management from 12 States. Dr. Oberle also assisted the MOH in preliminary planning for

Page 2 - James 0. Mason, M.D., Dr.P.H.

the workshop from October 22-23, in conjunction with travel to Panama.

Previous trips related to this workshop were carried out by Mark Oberle (See

This

Oberle Foreign Trip Reports dated August 19, and September 15, 1986). City

USAID/Mexico and of AID/S&T/POP/FPSD the request out at travel was carried and was in accordance with the Resource Support Services Agreement between AID

and CDC/CHPE/DRH.

II.

PRINCIPAL CONTACTS

A.

Ministry of Health, Family Planning Directorate

1. Dr. Manuel Urbina, Director General

2. Lic. Jose Luis Palma, Chief, Logistics and Planning Department (LPD)

3. Georgina Torres, Assistant Chief, LPD

4. Marisela Camacho Pineda, Chief ot Logistics

B.

Ministry of Health, Other Directorates

1. Ing. Alfonso Cardena, Administration

2. Dr. Ramiro Moreno, Immunization

3. Dr. Edmundo Hernandez, Malaria

4. Dra. Rosalinda Torres, Nutrition and Oral Rehydration

5. Ing. David Cabello, Region II

6. C. P. Rodolfo Hernandez, Central Warehouse

C.

USAID/Mexico City

1. Sam Taylor, Health and Population Officer

2. Magdalena Cantun

D.

Development Associates

1. Dr. Raul Guillermo Toledo

III.

LOGISTICS MANAGEMENT WORKSHOP

The workshop was developed to train administrators and planners from the 12 decentralized State health offices in the management of supplies for the 5 priority health programs: Nutrition, Oral Rehydration, Immunization, Malaria, In the past, State health offices were under close and Family Planning. control of the Federal office; under "decentralization" they have considerable autonomy, including purchase of some supplies. The workshop was based largely on an earlier international workshop on contraceptive logistics management presented by CDC and Development Associates in Bogota, Colombia (See Colombia The Colombia workshop had been Foreign Trip Report dated February 7, 1986). for the Mexico workshop coordinator the attended by Jose Luis Palma, who was The Mexico workshop design was such that and Ing. Cardena and Ms. Camacho. of CDC-developed theoretical material was presented using modifications training modules, followed by presentations specific to each of the five

priority programs.

The first week spent in Mexico City was devoted to review of the training

material and discussions with workshop faculty concerning content of sessions.

prepared additional

The individual programs, including family planning, With the addition

to review. material which we were not given the opportunity of these supplemental items, the written materials weighed 17 pounds per

participant, and program specific material (with the exception of the family

planning materials) contained little solid information related to logistics.

IV

Page 3 - James 0. Mason, M.D., Dr.P.H.

effort was

While there were plans to rehearse many of the sessions, this a National

was City Mexico in week the hampered by the fact that Thursday of

holiday, and many took Friday off, as well.

There were 2 partici­ The workshop was held at Tenacatita, near Manzanillo. The

total of 24. pants from each of the 12 decentralized States, for a is Attachment

schedule is attached as Attachment A, and a list of participants B.

to establish a basic

The workshop fulfilled only part of its objectives: interchange between

an for understanding of logistics priiciples, and to allow There was very little tendency for the

the States and the Federal offices. State participants to focus on their logistics systems in a problem-solving

detailed, often

and planning manner. Since so much of the time was spent in five priority

irrelevant and repetitive presentations from each, of the which were

exercises, module the of many programs, there was no time for general,

In system. logistics their designed to focus the participants onto for it

participants, the to however, the workshop was considered valuable newly

clarify to established some common terminology and gave an opportunity comments

specific established State-National government relationships. Some relating to the major modules follow:

Introduction to the Logistics Cycle

at the

The exercise programmed for this module was arbitrarily replaced since

mistake, major a was This last moment by our Mexican counterparts.

on

participants the focus to the exercise which was not used is designed for

basis a forms and system, the data they need to manage their logistics (a vague

the modules which follow. The "exercise" which was used instead "what are your problems" exposition) diverted the participants from their

intergovernmental

involving generalities into system own logistics communication problems.

?rogramming (needs projections)

section was

With the exception of the family planning presentation, this was the

presentations renetitive and nonspecific. A major result of the and

levels, lower at sense that projections and planning cannot be done

levels.

lower that it should be centralized and supplies pushed out to Acquisition

of purchasing for

Too much attention focused on the legal aspects it was deleted

scheduled, was Although an exercise

government agencies. by our Mexican counterparts.

Distribution

Because of a lack of formal practice in the previous week, the presenta-

did not leave

tion of this key session was not adequate, and participants with a full understanding of the importance of certain basic principles,

There was no

such as establishment of a maximum/minimum logistics system.

exercise,

discussion regarding push and pull systems, and the push/pull omitted.

was problems,

local on which would have focused the participants

Page 4 - James 0. Mason, M.D., Dr.P.H.

Warehousing

Because of the length of program-specific presentations, there was no time

to discuss certain subjects under this topic.

Computerization

Because of the substitution of the first exercise, the participants did not

know what specific information they needed to run their logistics systems;

so the utility of the logistics monitoring programs was not apparent.

There was a presentation of the capabilities of the system used at the

However, it was not clear how

national level for logistics management. such a system could be useful at the State or local level.

Problem-Solving

This session was totally changed at the last minute. The didactic section

The

became a summary of the workshop, and the exercise was deleted. original exercise, again, was designed to focus attention on local

problems.

IV.

CONCLUDING COMMENTS

Although the workshop succeeded in improving State/Federal relations, very

Since the

little improvement in logistics will result from this workshop. State participants focused largely on concerns outside their own States, there

However, two

was no immediate demand for further workshops within States. technical

in receiving interest expressed Colima, Jalisco and States, of

microcomputerization including assistance from CDC in logistics management, more

for These States could be pilot locations their logistics systems. general computer applications in Mexico.

Anthony A.

udgins, M.A.S.

Mark W. Oberle, M.D., M.P.H.

Attachment A

SEMINARIO DE LOGISTICA DE SUMINISTROS PARA LOS PROGRAMAS

PRIORITARIOS DE LA SSA EN LOS ESIADOS DESCENTRALIZADOS

PROGRAMA DE ACTIVIDADES

Lunes 24 de noviembre,

1986

8:30-8:40

EXPOSI IOR

I E M A

H 0 R A

INAUGURACION

DR.

MIGUEL CASIELLANOS

MANUEL

I. PRESENIACION

8":40-8 :50

1. Objetivos

DR.

8:50-9 :00

2. Oirlrnica de traba jo del Seminario

LIC.

ni1.

(15

10:30-10:40

1. Concepto

10:'40-10:50

2. Importancia gIstica

4.

III.

la

de

ING.

ALFONSO

CARDENA

ING.

ALFONSO

CARDEIA

ING.

ALFONSO

CARDENA

Lo­

ciulo

Participantes estados

Ejerci cio

de

los

PROGRAMACION GUILLERMO

,

DR.

GUILLERMO TOLEDO

I rforinaci6n

DR.

GUILLERMO

1.

Introducci6n

11:50-12:20

2.

M6todo de

12:20-12:40

3.

Fuentes

12 :40-13:00

4.

Programaci

de

6

6 n Bases de Programaci en Los Programas Pria ritari os

iii,,.

(20

C

14 :30-15 50

4. (cont.)

15:50-16:05

R

E

ResponsabIes Central

TOLEDO

Nivel

C/U)

M

0

13:00-14:30

TOLEDO

DR.

11:35-11:50

18:00

0

S

CICLO LO

3. Descripci6n del Logistico

11:10-11:35

PALMA

Responsables Nivel

Central

E

C

II. INTRODUCCION AL GIST ICO

10:50-11:10

JOSE LUIS

c/u)

E

R

10:15-10:30

16:05-18:00

de

3. Des.cripci6ri GraI. Los Programas

9:00-10:15

URBINA F.

I

Bases

de Pro .

C

E

E1aboraci6n de acci6n

A

D

S

Responsables Central

NiveI

0

de planes

Grupos

de trdbajo

Reuni6n de Representari tes de grupo

I. ,5

1986

Martes 25 de noviembre,

EXPOSITOR

TEMA

HORA IV.

ADOUISICION

5:30-

8 :40

1. Introducci6ri

ING. ALFONSO CARDENA

8:40-

q:00

2. Marco Normativo

ING.

9:00-

9:20

3.

9:20- 10:00 10:00-11:00

Fuentes de Adquisici6r

ING. ALFONSO CARDERA

Participantes de los estados

4. Ejercicio 5.

La Adquisici6n el los Programas Prioritarios R

11:00-11:15

ALFONSO CARDENA

0

S

E

C

E

ResponsabIes de niveI ce tit ra1

V. DISTRIBUCION 11:15-11 :25

1.

Irntroducci6n

LIC.

GEORGINA TORRES

11:25-11:40

2.

Tipos de I iformaci6i

LIC.

GEORGINA 1ORRES

11:40-12:10

3. Minimos y M5ximos

LIC.

GEORGINA TORRES

12:10-12:30

4. Determinaci6n de Sunil­ nistros

LIC. MARISELA CAMACHO

12:30-13:00

D

A

6. Sistema de Asigriaci 6r' y Requisici 6 n

LIC.

C

13:00-14:30 14:30-14:45

M

0

I

7. Ejercicio

15:20-15:45

8. Evaluaci 6 n del estado

de existencias R

16:00-17:30 17:30-18:00

E

C

E

S

9. Ejercicio 10.

LIC.

Los

JOSE LUIS PALMA

0

Grupos de estados

Lirieamientos de la DGA para la distribuci6n

18:00-

MARISELA CAMACHO

Participa ntes de estados

14:45-15:20

15:45-16:00

los

Pdrticipantes de estddos

5. Ejercicio

Reuni6rr de Representantes

de grupo

LIC. RODOLFO HERNANOEZ

Miercoles

26 de

roviembre,

198_

EXPOSITOR

T E M A

H 0 R A

V. DISTRIBUCION (cont.) 8:30-9:30

11.

6 La Distribuci n en mas Prioritarios

9:30-10:10

12.

6 Sistemas de Distribuci n en los Estados

10:10-10-30

13.

Conclusjones de Los grupos

los Progra

Responsables del Nivel Central

Gurpos de estados

VI. ALMACENAMIENTO DR. MARK OBERLE

10:30-10:40

1. Introducci6n

10:40-11:05

2. Pautas para Almacenamiento

11:05-11:20

S

E

C

RE

Participantes de los estados

Ejercicio

11:20-11:40

3.

11:40-12:00

4. Requerimientos de espacio

12:00-12:15

5.

12:15-12:45

6. Ejercicio

12:45-13:00

7. Resumen

de existerncias

Control

DR. MARK OBERLE

DR.

MARK OBERLE

DR.

MARK OBERLE

Participantes de los estados DR. MARK OBERLE

Elaboracion de planes de

13:00-14:00

Grupos de trabajo

Acci6n

Reuni

6

n de Representantes de

grupos C

0

M

1

0

A

Jueves 27 de noviembre,

1986

H 0 R A

EE M A VI.

ALMACENAMIENTO (cont.)

8. Lineamientos de la OGA para el

Aimacenamiento

8:30- 9:00

9:00-10:15

R

11:15-11:45

11.

15:40-15:55

15:55-16:30

16:30-18:00

18:00

E

S

Conclusiones de los grupos

Grupos de estados

0

1. Presentaci6n de un paquete para

Logfstica

LIC. ANTHONY HUDGINS

ING. ALFONSO CAROERA

2. Sistema microc6mputo

de la OGA

13:00-14:30

15:20-15:40

C

Ni­

7VII.COMPUTACION

12:15-13:00

14:50-15:20

E

GRANILLO

Responsables del vel Central

10. Sistemas de Almacenamiento

en

los Estados

11:00-11:15

14:30-14:50

LIC. JORGE

9. Aimacenamiento de los suminis

tros de 1os Programas Prioritd

r as

10:15-11:00

11:45-12:15

EXPOSITOR

C

:/VIII.

0

M

I

0

A

SOLUCION DE PROBLEMAS

1. Elemerttos para la solucj6n practi

ca de problemas

2. Ejercicios

E

C

E

CELSO CAMPOS

Participantes de los

estados

LIC. JOSE LUIS PALMA

IX. RESUMEN DEL SEMINARIO

R

DR.

S

0

X. DIAGNOSTICO Y LINEAS

DE ACCION DE

LA OGA

ELaboraci6 de Planes de

Acci6n

Reuni6n de representantes

de

grucno

Grupos de trabajo

Viernes 28 de noviembre, 1986 H 0 R A 8:30-10:30

T E M A

EXPOSITOR

Elaboraci6n de planes de Acci6n

Grupos de trabajo

10:30-11:45

Integraci6n de la relatoria

Representantes de los grupos

11:45-12:00

R

12:00-13:00

Presentaci6n de resultados

Relatores

13:00-13:30

Conclusiones

DR. OSCAR HERRERA I.

E

C

E

S

0

DR. GABRIEL GARCIA P. DR. MANUEL URBINA F.

CLAUSURA

LIC. ROBERTO ORTEGA L.

Attachment B

Workshop Participants

State

Baja California Sur

Ing. Luis Jimenez Campos

Lic. Ismael Garcia Meza

Colima

Dr. Jose de Jesus Alcaraz Mercado

Ing. Jorge Arturo Tellez Aguilar

Guanajuato

Lic Rosendo Fernandez Gutierrez

Ing. Alfredo Herrera Rocha

Guerrero

C.P. Olivia Jimenez Herrera

Jalisco

C.P. Guillermo Elizalde Gutierrez

Mexico State

Dr. Heriberto Vilchis Hernandez

Ing. Ernesto Aburto y Olivas

Dr. Carlos Gonzalez Ramirez

Morelos

Lic. Ma. de Lourdes Acevedo Vargas

C.P. Carlos C. Olvera Cruz

Nuevo Leon

Lic. Luis Gerardo Gomez Guzman

C.P. Eloy Gonzalez Canales

Queretaro

Lic. Victor M. Velazquez Ramirez

C.P. Teresa Pina Coronel

Sonora

Dr. Andres Corrales

C.P. Manuel Orrantia Fonseca

Tabasco

Lic David Castro Garcia

C.P. Lauro Alvarez Zurita

Tlaxcala

Lic. Ma. Del Carmen Diaz y Cruz

Lic. Luis Corona Velazquez